| Objective: Through a retrospective controlled study,observe the curative effect of unstable distal radius fracture by external fixation or internal fixation and the early effect of taking Yipanzhu decoction,to provide reference and evidence for the selection of treatment.Methods: The study systematically reviewed the records of distal radius fracture in traditional medicine and modern medicine, analyzing the etiology and pathogenesis in TCM, anatomy,type of fracture and treatment.61 unstable distal radius fracture cases were collected from January 2014 to September 2015 in hubei hospital of tcm.All cases were treated by external fixation or internal fixation.Yipanzhu decoction was taken by patients according to their wishes.There were 22 cases took Yipanzhu decoction.The other 39 cases were treated only by surgery,while 20 of them were treated by external fixation and 19 of them were treated by internal fixation.We compared the palm tilt, radial tilt and radial shortening before surgery and one week,6 weeks and 6 months after surgery according to the X-ray of the wrist between the two simple surgery groups as well as the range of wrist motion after 6 months.All patients were analyzed by Garland-Werley Scoring System.While the pain and swelling were compared between the tcm group and non-tcm group by take notes of relieving time.Results: Simple external fixation group and internal fixation group:All 39 cases were followed for 6-12 months,average of about nine months.All patients Meet clinical healing standard.The healing time range from 5-10 weeks,average of about seven weeks.One suffered superficial stent-tract infection in external fixation group,and been cured by medication and anti-infection therapy.While one suffered limit of extension-flexion motion in internal fixation group,also got improvement by functional training.There were no statistically significant differences between the two group on age,sex,side and type of fracture(P>0.05). Statistically significant difference was showed in surgery time(P<0.05). External fixation group was 31.85±3.2 mins,less than internal fixation group of 76.05±7.2 mins.No significant difference showed on the fracture healing time(P>0.05).There were statistically differences on the palm tilt(P<0.05).Internal fixation(9.50±1.16 after one week,9.52±1.14 after six weeks,9.54±1.13 after six months) got better recover than external fixation(8.53±1.56 after one week,8.57±1.51 after six weeks,8.65±1.41 after six months).But no significant differences showed in radial tilt and radial shortening(P<0.05).External fixation got better extension-flexion motion(85.05±2.61%) than internal fixation(82.11±4.50%)while the other motion of wrist showed no significant difference.The excellent and good rate of wrist function by G-W system showed no significant difference(P<0.05).The external fixation group got nine excellent,eight good and three middle while the internal fixation group got ten excellent,six good and three middle.Tcm group and non-tcm group: There were no statistically significant differences between the two group on age,sex,side,type of fracture and selection of surgery(P>0.05).There were statistically significant difference in the time of detumescence and pain relieved(P<0.05).The tcm group(detumescence 7.06±1.90 d,pain relieved 5.64±1.17d) needs less time than control group(detumescence 8.90±2.49 d,pain relieved 6.56±1.02d).Conclution: Both external fixation and internal fixation can get satisfying curative effect on treating unstable distal radius fracture.The external fixation needs less surgery time and got better extension-flexion motion,the internal fixation got better recover of palm tilt.Taking Yipanzhu decoction after surgery can early relieve pain and swelling. |
